Air pollution exposure, health and performance in elite female soccer players.

Introduction: Acute exposure to air pollution negatively affects athletes' ability to perform at their best, with a more pronounced impact observed in females. Despite this, the representation of female-only cohorts is lacking. This study investigates how exposure to air pollution impacts performance and well-being of an elite female soccer team. Methods: Comprehensive data on external, internal, and subjective load variables were combined with the concentrations of three major air pollutants (Particulate Matter >10 µm and Oxidant (Ox = Ozone + Nitrogen Dioxide) during soccer training and matches in the 2022-23 season. Linear mixed-effects models assessed performance parameters such as distance ran, heart rate, rating of perceived exertion (RPE), accounting for confounding factors such as weather and menstrual cycle phase. Results: No significant impairments in the physical or physiological demands of athletes were observed with increasing pollution concentrations, nor did athletes' well-being appear to be disturbed. However, RPE increased by 0.84 units ( Discussion: While objective performance measures remained largely unaffected by moderate levels of air pollution, players subjectively experienced a heightened sense of effort. Additionally, an acclimation effect was observed regarding preceding Ox exposure, whereby accounting for pre-event exposure levels to Ox appeared to mitigate the negative impact of high Ox levels on RPE.